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February 16, 2009

OK, so that’s just a salacious title. Your veterinarian may well recommend pet health insurance. I do, so that makes … um … two of us.   

Okay, maybe I exaggerate. It’s clear that veterinarians increasingly buy into pet health insurance. When faced with very sick patients whose owners hold insurance policies for them, we breathe a sigh of relief. In our experience these clients more readily accept our recommendations to treat their pets. More and more of us see pet health insurance as a positive influence on patient care — not to mention out bottom lines. Yet even those of us who wholeheartedly endorse it tend to tread lightly on the subject, as if we’re well aware that we should be careful what we wish for. Heaven forbid that blue genie in the bottle should turn around and bite us in the butt once he’s freed.

Pet health insurance is something veterinarians have plenty of cause to contemplate; it’s just that the pet health insurance industry wishes we would do so more frequently and with greater dedication. They would have us recommend specific plans, carry brochures in our waiting rooms, dedicate a staff member as the "insurance rep," ask about insurance each time an appointment is scheduled or a client arrives, etc. So says a much-anticipated report issued this past January — just in time for the veterinary behemoth that was the North American Veterinary Conference in Orlando.

My schedule being what it is, I just finished reading it this weekend. Titled, A Veterinarian’s Guide to Pet Health Insurance: How pet insurance affects the practice, the client and the patient, it does a pretty good job of explaining why pet insurance improves our patient care and props up our sagging bottom lines, all the while strongly insisting that pet insurance absolutely does not usher in the specter of managed care.

Back to that blue genie … managed care is what veterinarians fear. More than a new parvo pandemic or a feline form of bird flu, veterinarians in small animal practice shoulder extreme anxiety over the possibility that pet health insurance will one day approximate human HMOs and PPOs in their design. Where did we get this idea? When was the last time you waded through the human healthcare system with impunity? The authors of this report at the NCVEI (National Commission on Veterinary Economic Issues) absolutely refute this possibility. They swear up and down in a four-point list that pet health insurance, like dental insurance, will never go HMO. And if the dental model hasn’t gone to managed care, why should the veterinary version?

The possibility that the human healthcare model might ride in on a Trojan horse that looks on the surface like dental-slash-auto insurance is what many of us continue to fear. At least that’s the common excuse for effectively steering clear of pet health insurance as an exam room subject. But there are more issues. Even those of us who’ve gotten past the managed care melodrama have cause to consider the following points:

a) It’s not my job to push insurance — how tacky is that?

b) I’m not an expert in insurance so how can I advocate any one plan?

c) It’s the purview of the pet health insurance companies to market this stuff — why should I do their job for them?

d) If I do recommend a plan and my clients aren’t happy, how will that reflect on me?

e) Why should I take time out to discuss insurance when I get nothing for it?

f) All of the above.


I’m down with points a) through f). I get it. I struggle with the same rational arguments. But I still actively recommend pet health insurance. Why? My take is that if I believe that pet health insurance is something that, on balance, helps my clients access better care (which this publication helps make plain with its helpful data and parallels to the human dentistry model), then as a veterinarian it’s my duty to raise the issue.

Still, I recognize that my U.S. colleagues are extremely reluctant, far more so than in other countries. And, given this finding, it really does seem to be the HMO model that keeps veterinarians wringing their hands with angst. Yet it’s also clear to me that pet health insurance will never break into the mainstream within the next decade without the assistance of veterinary professionals. That’s why I welcome this publication. In spite of its suspiciously glowing spin on pet health insurance, its impressive recommendations for veterinary practice intervention and its pet insurance industry backers, I have to concede that in the end, if it’s legitimately investigated, independently written, and thoroughly credible, it’s one more real-world tool for helping veterinarians get past the managed care "ick" factor.

For now, however, the standoff between veterinarians and the pet health insurance industry continues unabated. This saga’s got more nuances than a Henry James novel. But, optimist that I am, I see a happy ending evolving somewhere within three to five years. That’s my prediction. And you can hold me to it.

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